Vision and Hearing Screenings!

  1. Concerning my PreK and Early Intervention age out kiddos...

    When I have a student who is unable to screen for hearing, I will make a referral to the audiologist based out of our special ed co-op, HOWEVER, I don't have that type of option for vision.

    What do you guys do with the "unable to screen" for vision screenings? (not the "fails" but the kiddos who just couldn't grasp the concept for whatever reason: medical diagnosis, developmental delay, etc.)

    Obviously, my first step would be to ask the parent to see if they've been seen by an ophthalmologist/optometrist, but what if they haven't? What is your next step? Referral to an ophthalmologist/optometrist?


    Thanks in advance
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    About jess11RN

    Joined: Jan '18; Posts: 80; Likes: 180

    12 Comments

  3. by   LikeTheDeadSea
    My state has guidelines on special ed modifications / interpretations that can be used as a vision screening.

    Also, "when in doubt, refer out." Although, if a primary physician screens and passes them, I'll accept that as a follow-up, since many of my local physicians have screening tools for special needs students that I don't have.
  4. by   OldDude
    We have 2 Automated Vision Screeners in our district. That has been very helpful. Prior to that we would do an "alternative" vision screen. Stuff like tracking a light, picking up small objects, corneal light reflex, general observations indicating a visual deficit, parent input, etc.

    Lions Club might be able to come screen those littles for you.
  5. by   ruby_jane
    There is a way to do functional vision testing (as OD describes). I have to figure it out soon because I have three that have their ARDs at the beginning of the bleeping year! Good luck!
  6. by   kidzcare
    We send a referral a letter with a note that the child may not have understood the test.
  7. by   UrbanHealthRN
    When I worked in primary care, if a child was too young to do a vision screening, we'd have the family come back in 3-6 months for a re-try. If the parents had an actual concern, or the doctor found something abnormal, then we wouldn't wait and would just refer to ophtho.

    Here with the pre-k kids, I re-try in about a month. Especially right now, with our new students having to learn so much about what school is and who people are, I'm not expecting many successful screens. If I feel the child isn't comfortable yet with the staff here, I'll also consider asking the pedi to do the screening, because that may be a person the child is more familiar with.

    If we get two failed screenings, then we notify the parent and pedi and request follow-up.
  8. by   tamarae1
    Find the policy on a functional vision screen and submit that if you don't have time to have them learn their letters. I'd ask the pre-k teachers to start having kids recognize the HTOV letters from the first of the year so they could be screened with more confidence by matching what I point to to the card I have them hold.

    Automated screeners are amazing if you have access to them.
  9. by   Farawyn
    What is automatic screening? Link?
  10. by   tamarae1
    Like the Welch Allyn Spot Vision Screener.
  11. by   OldDude
    Quote from tamarae1
    Like the Welch Allyn Spot Vision Screener.
    That's what we have. A Welch Allyn rep will do the certification. In Texas you can only screen 5 years and under or any student who can't comprehend a wall chart screening.

    Attention Texas school nurses...starting this year the HOTV and Sloan letters chart are the only approved charts. The tumbling E is out.
  12. by   Amethya
    Quote from OldDude
    That's what we have. A Welch Allyn rep will do the certification. In Texas you can only screen 5 years and under or any student who can't comprehend a wall chart screening.

    Attention Texas school nurses...starting this year the HOTV and Sloan letters chart are the only approved charts. The tumbling E is out.
    I know I saw this. I'm actually a bit happy but also not so much because my Kinders sometimes don't understand their alphabet and it's harder to do their vision.

    I got this program doing the eye vision for me and they are using the vision screener, which will make my life SOO much easier. Trying to wrangle Kinder and 1st is like trying to control baby chicks, it can't be done.
  13. by   jess11RN
    Thanks everyone! I was busy screening my elementary school all last week, so I am just seeing all of your responses.
    I will definitely look into the functional vision screening. Unfortunately, the state of IL doesn't recognize the automated vision screener as an official screening device...very frustrating!

    And, yes, I do have the PreK teachers condition the kids with the HTOV letters and I even found a video on YouTube that plays the tones for hearing screening. They put a picture of my face on a stick and practice the seeing and hearing "games" during their circle time for the week before I come in. It's awesome!! Because of this, my only "Unable to Screens" are usually only the kids who are either autistic or fairly delayed. It makes my job significantly easier and the teachers and therapists get legit screening results.
  14. by   Amethya
    That's great that they are preparing them for the screening!

    I had issues last year because of Harvey, kids didn't get to learn their letters by the time screenings come in. I had to re-screen and thankfully a lot passed.

    I wish you luck!

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